Calls for MU Stage 3 Delay Get Louder

Sept. 18, 2015
The American Medical Association (AMA) has made no secret in its desire to push back rulemaking for Stage 3 of the meaningful use program. Now, it has the official support of 41 medical societies.

The American Medical Association (AMA) has made no secret in its desire to push back rulemaking for Stage 3 of the meaningful use program. Now, it has the official support of 41 medical societies.

In letters delivered to U.S. Department of Health & Human Services (HHS) Secretary Sylvia M. Burwell and Office of Management and Budget (OMB) Director Shaun Donovan, AMA and the medical societies urged the administration to pause the final stages of the federal government’s meaningful use program in light of pivotal changes to Medicare. 

The physician organizations noted that the proposed Stage 3 regulation was developed prior to and without consideration of the changes enacted by the Medicare Access and Chip Reauthorization Act (MACRA). Given the vital role of the meaningful use program in the reformed payment systems introduced by MACRA, proceeding with the proposed Stage 3 rules threatens to impede the healthcare delivery innovations Congress sought to promote when it passed the law, the letter stated.

The letter reads, “To date, 80 percent of physicians are utilizing EHRs, but less than 10 percent of physicians have successfully participated in MU Stage 2. Furthermore, due to the inflexible MU regulations and certification requirements, vendors have created software products that are frequently unusable, administratively burdensome, and in many instances do not promote clinically relevant patient care.”

AMA President Steven J. Stack, M.D. added in a statement, “There is growing bipartisan recognition in Congress that the direction of the meaningful use program needs to be reassessed in light of usability and interoperability challenges with electronic health record systems. Poorly performing systems that do not facilitate the seamless exchange of data would severely undermine the ability of the health system to support the implementation of the payment reforms outlined in MACRA.”

The AMA believes that pausing Stage 3 at this time will provide the opportunity to evaluate the environment and work with the administration to implement the needed changes to the meaningful use program that are currently under consideration.“ The AMA wants the meaningful use program to succeed. Pausing to reassess Stage 3 rules will not stop or delay progress with EHRs,” said Dr. Stack. “On the contrary, we firmly believe a temporary period of reevaluation will help move the program forward and drive innovation and adoption.”

Similarly, in July, AMA backed legislation by Congresswoman Renee Ellmers (R-NC), who introduced H.R. 3309—the Further Flexibility in HIT Reporting and Advancing Interoperability Act (or Flex-IT 2 Act)—which proposed, among other things, to delay Stage 3 rulemaking until at least 2017, or until Merit-based Incentive Payment System (MIPS) final rules, or until at least 75 percent of doctors and hospitals are successful in meeting Stage 2 requirements. As such, in the new letters to HHS an OMB, AMA also urged the feds to proceed with finalizing the Stage 2 Modifications Rule as well as with integral pieces of the proposed 2015 Edition Certification Rule as soon as possible. Earlier this month, the Centers for Medicare & Medicaid Services (CMS) sent the final rules for both meaningful use Stage 3 and Stage 2 modifications to OMB for review.

Perhaps starting the Stage 3 delay momentum, just this week, during a Senate hearing, Sen. Lamar Alexander (R-TN), Chairman of the Senate Health Education Labor and Pensions (HELP) Committee, once again pushed for a delay himself, citing the need to push back the making of a final rule until Jan. 1, 2017 due to physicians telling him they are “terrified” of the impending stage of the program. Not surprisingly, AMA backed those sentiments as well. Nonetheless, most indications are that the final rules for both Stage 2 modifications and Stage 3 will be signed by OMB and published in early fall.

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